Wu Xianxiang,Cai Hanfei,Cao Lu,et al.Pinnacle script-based construction of automatic intensity-modulated radiotherapy plans for cervical cancer[J].Chinese Journal of Radiological Medicine and Protection,2024,44(8):650-656
Pinnacle script-based construction of automatic intensity-modulated radiotherapy plans for cervical cancer
Received:October 22, 2023  
DOI:10.3760/cma.j.cn112271-20231022-00133
KeyWords:Cervical cancer  Automated planning  Intensity-modulated radiotherapy  Dosimetry
FundProject:蚌埠医学院自然科学重点项目课题(2020byzd160)
Author NameAffiliationE-mail
Wu Xianxiang Department of Radiation Oncology, First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China  
Cai Hanfei Department of Radiation Oncology, First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China hfcai545@163.com 
Cao Lu Department of Radiation Oncology, First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China  
Li Wei Department of Radiation Oncology, First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China  
Xu Lu Department of Radiation Oncology, First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China  
Ge Wenjie Department of Radiation Oncology, First Affiliated Hospital of Bengbu Medical University, Bengbu 233004, China  
Fei Zhenle Department of Radiation Oncology, No. 901 Hospital of PLA, Hefei 230031, China  
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Abstract::
      Objective To explore the feasibility of constructing automatic intensity-modulated radiotherapy (IMRT) plans for cervical cancer based on Pinnacle scripts and to assess the advantages of this method in designing treatment plans for cervical cancer. Methods A retrospective analysis was conducted for 40 cases of cervical cancer treated with IMRT in the department of radiation oncology of the First Affiliated Hospital of Bengbu Medical University. Among them, the data of 25 cases were employed as a reference for the initialization of objective functions. The scripts for automatic plans were designed in the Pinnacle planning system. For the remaining 15 cases, automatic and manual IMRT plans were designed (also referred to as the automatic planning group and the manual planning group, respectively). The design times of both groups were compared. Furthermore, both the dosimetric parameters of target volumes and the irradiation doses to organs at risk (OARs) were also compared between the two groups using dose-volume histograms. Results Compared to the manual planning group, the automatic planning group exhibited a statistically significant decrease in the average design time of 32.81 min (t = -12.91,P < 0.05), a statistically significant increase in the conformity index of the target areas of 0.01 (t = -0.08,P < 0.05), and a decrease in the uniformity index of the target areas of 0.02. Compared to those of the manual planning group, the bladder's V40 and V45 and the rectum's V40 and V45 of the automatic planning group decreased by 6.88%, 4.12%, 9.93%, and 12% on average, respectively (t = -4.49, -4.46, -3.62, -5.80,P < 0.05). Minimal differences were observed in the V30, V50, and Dmax of the small intestine between both groups, without statistically significant differences in V30 and Dmax (P > 0.05). Compared to the manual planning group, the automatic planning group displayed decreases in the V45 and Dmeanof the bilateral femoral head of 7.9% and 106.83 cGy, respectively and a decrease in the spinal Dmax of 100.14 cGy, with statistically significant differences (t = -6.00, -2.52, -2.55,P < 0.05). Conclusions Automatic IMRT plans for cervical cancer, constructed based on Pinnacle scripts, can significantly reduce irradiation doses to OARs and enhance the efficiency of the plan design while ensuring dose uniformity and conformality of target areas.
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